Tag Archives: epidemiology

A team of Swedish scientists have used national registries encompassing more than one million Swedish children to study the association between early life contact with dogs and subsequent development of asthma.

The new study found that children who grew up with dogs had about 15 percent lower risk of asthma than children without dogs.

Tove Fall is Assistant Professor in Epidemiology at the Department of Medical Sciences and the Science for Life Laboratory.Photograph: Mikael Wallerstedt

A total of more than one million children were included in the researchers’ study linking together nine different national data sources, including two dog ownership registers not previously used for medical research. The results are being published for the first time in JAMA Pediatrics. The goal was to determine whether children exposed to animals early in life are at different risk of asthma.

‘Earlier studies have shown that growing up on a farm reduces a child’s risk of asthma by about half. We wanted to see if this relationship also was true also for children growing up with dogs in their homes. Our results confirmed the farming effect, and we also saw that children who grew up with dogs had about 15 percent less asthma than children without dogs. Because we had access to such a large and detailed data set, we could account for confounding factors such as asthma in parents, area of residence and socioeconomic status’ says Tove Fall, Assistant Professor in Epidemiology at the Department of Medical Sciences and the Science for Life Laboratory, Uppsala University. She coordinated the study together with researchers from Karolinska Institutet in Stockholm, Sweden.

In Sweden, every person carries a unique personal identity number. Every visit to a specialist physician and every prescription made are recorded in national databases, accessible to researchers after de-identification of data. Even dog ownership registration is mandatory in Sweden since 2001. These scientists studied whether having a parent registered as a dog-owner or animal farmer was associated with later diagnosis or medication for childhood asthma.

’These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how animals could protect children from developing asthma. We know that children with established allergy to cats or dogs should avoid them, but our results also indicate that children who grow up with dogs have reduced risks of asthma later in life. Thanks to the population-based design, our results are generalizable to the Swedish population, and probably also to other European populations with similar culture regarding pet ownership and farming‘ says Catarina Almqvist Malmros, senior author of the study, Paediatrician at Astrid Lindgren Children’s Hospital and Professor in Clinical epidemiology at Dept of Medical Epidemiology and Biostatistics at Karolinska Institutet, Stockholm.

The use of dogs in hospitals and other therapy institutions is on the rise, as more medical professionals acknowledge the positive effects of dogs on human patients.

New expert guidance by the Society for Healthcare Epidemiology of America (SHEA) outlines recommendations for developing policies regarding the use of animals in healthcare facilities, including animal-assisted activities, service animals, research animals and personal pet visitation in acute care hospitals.

The guidance was published online in Infection Control & Hospital Epidemiology, the journal of SHEA.

“Animals have had an increasing presence in healthcare facilities,” said David Weber, MD, MPH, a lead author of the recommendations. “While there may be benefits to patient care, the role of animals in the spread of bacteria is not well understood. We have developed standard infection prevention and control guidance to help protect patients and healthcare providers via animal-to-human transmission in healthcare settings.”

Guidance is grouped by the role of animals – animal-assisted activities (i.e., pet therapy and volunteer programs), service animals, research animals and personal pet visitation. Select recommendations include:

Animal-Assisted Activities

Facilities should develop a written policy for animal-assisted activities. An animal-assisted activity visit liaison should be designated.

Allow only dogs to serve in animal-assisted activities, such as pet therapy.

Animals and handlers should be formally trained and evaluated.

Animal interaction areas should be determined in collaboration with the Infection Prevention and Control team and clinical staff should be educated about the program.

Animal handlers must have all required immunizations, restrict contact of their animal to patient(s) visited and prevent the animal from having contact with invasive devices, and require that everyone who touches the animal to practice hand hygiene before and after contact.

The hospital should maintain a log of all animal-assisted activities visits including rooms and persons visited for potential contact tracing.

Service Animals

The policy allowing service animals of patients and visitors into the facility should be compliant with the Federal Americans for Disability Act (ADA), other applicable state and local regulations and include a statement that only dogs and miniature horses are recognized as Service Animals under federal law.

If an inpatient has a service animal, notification should be made to the Infection Prevention and Control Team, followed by discussion with the patient to make sure the owner of the service animal complies with institutional policies.

Healthcare providers or staff may ask the patient or visitor to describe what work/tasks the dog performs for the patient, but may not ask for a “certification” or “papers.”

Personal Pet Visitation

Pets should, in general, be prohibited from entering the healthcare facility.

Exceptions can be considered if the healthcare team determines that visitation with a pet would be of benefit to the patient and can be performed with limited risk. Even then, visitation should be restricted to dogs.

The patient must perform hand hygiene immediately before and after contact with the animal.

The authors of the guidance also note that as the role of animals in healthcare evolves, there is a need for stronger research to establish evidence-based guidelines to manage the risk to patients and healthcare providers.

This guidance on animals in healthcare facilities has been endorsed by the Association for Professionals in Infection Control and Epidemiology (APIC), the leading professional association for infection preventionists with more than 15,000 members.